Tian Yu, Lv Huibin, Jumai Adilijiang, Tuerhong Tuersun, Zhuang Lihong, Huang Jia, Li Jiantao, Lu Peiji, Tao Guorong, Yamauchi Yoshikane, Flores Raja M, Teng Haohua, Chen Tianxiang, Luo Qingquan
Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Cardiothoracic Surgery, Kashi Prefecture Second People's Hospital, Kashi Prefecture, China.
J Thorac Dis. 2024 Dec 31;16(12):8823-8830. doi: 10.21037/jtd-24-1605. Epub 2024 Dec 27.
Robot-assisted thoracic surgery has been shown to have several advantages over conventional surgery. As mobile communication technology and surgical robotic devices in China continue to progress rapidly, the conditions for performing remote surgery have been optimized. Consequently, informatized and remote advanced medical cooperation is becoming a new direction for supporting the medical development of border regions and promoting the equitable distribution of medical resources in China.
In this case, a 53-year-old female patient in Kashi was admitted with a mixed ground-glass lesion in the right upper lobe. The size and density of the lesion were found to be increasing progressively. After a comprehensive multidisciplinary team consultation, the patient was clinically diagnosed with early stage lung cancer. The patient gave informed consent to undergo remote robot-assisted right upper lobectomy and lymph node dissection, which was performed on July 13, 2024 between Shanghai and Kashi using a dedicated network and 5G mobile communication. The procedure was successfully conducted with an average delay of 100 ms and no connection interruptions. Pathology and immunohistochemistry confirmed invasive mucinous adenocarcinoma (T1aN0M0). Postoperative imaging showed good lung re-expansion; the patient had an ideal recovery and was discharged smoothly.
We reported the first case in which a remote robot-assisted lobectomy was performed using a robotic surgical system, 5G technology, and corresponding procedures. More cohorts or clinical studies need to be conducted to further clarify the guidelines and promote the application of remote thoracic surgery.
与传统手术相比,机器人辅助胸外科手术已显示出诸多优势。随着中国移动通信技术和手术机器人设备的快速发展,远程手术的条件得到了优化。因此,信息化远程高级医疗合作正成为支持中国边境地区医疗发展、促进医疗资源公平分配的新方向。
在本病例中,喀什地区一名53岁女性患者因右上叶混合性磨玻璃病变入院。发现病变的大小和密度在逐渐增加。经过多学科团队综合会诊,该患者临床诊断为早期肺癌。患者签署知情同意书,接受远程机器人辅助右上叶切除术和淋巴结清扫术,于2024年7月13日在上海和喀什之间利用专用网络和5G移动通信完成手术。手术顺利进行,平均延迟100毫秒,无连接中断。病理及免疫组化结果确诊为浸润性黏液腺癌(T1aN0M0)。术后影像学检查显示肺复张良好;患者恢复理想,顺利出院。
我们报道了首例使用机器人手术系统、5G技术及相应程序进行远程机器人辅助肺叶切除术的病例。需要开展更多队列研究或临床研究,以进一步明确指南并推动远程胸外科手术的应用。